I reported earlier this month that a generic for Lipitor (the pricey drug designed to lower cholesterol levels) would be available this month, and that the patent on the even more expensive Azilect (commonly prescribed for Parkinson's) was due to expire next February. See http://bit.ly/tk3S3b.
While the plans for a generic Lipitor are now confirmed, we've learned that the Azilect patent, held by Israeli pharmaceutical giant Teva, has been extended for five years and will now expire in February, 2017.
That's bad news for those of us who use Azilect, whose high tariff -- in combination with Lipitor's -- pushed me into Medicare's "donut hole" last year. Now, Lipitor won't be the problem it was, but Azilect alone will drive me in the dreaded donut hole next year.
The donut hole opens in 2012 when my total drug cost (what I pay plus what my plan pays) hits $2,930. A 90-day supply of the 1.0 mg Azilect (my prescription) costs $938. Three refills of that 90-day prescription would just about reach my threshold. Add in the cost of the other meds I take, and I'll probably fall into the hole in mid-summer.
Once in the hole, those of us covered by Medicare must pick up the full tab until the total cost-of-meds hits $4,700. Luckily, we get a break because last year's Health Reform Law requires pharmaceutical companies to offer brand name drugs at half price.
What Options Are Available?
Assistance for the Low-Income Uninsured
For those without insurance, and whose incomes are 350% below the federal poverty level, Teva offers a patient assistance program. Last year, that program offered breaks for singles with incomes below $38,115, and for couples below $51,485. Details:
Online Canadian Pharmacies
Even though it's illegal to buy drugs abroad and bring them back into the U.S, the Food and Drug Administration has turned a blind eye to the busloads of Americans who have been crossing the border into Canada for years to buy lower-cost drugs from pharmacies there.
An aside: Remember the bus-to-Canada scene in the movie Love and Other Drugs? Maggie (Anne Hathaway) who has early-on-set Parkinson's is being pursued by Jamie (Jake Gyllenhaal) who wants a committed relationship but she resists. At a Parkinson's convention, Jamie asks the advice of a man whose wife is in the late stages of PD who tells him to run. Instead, when he learns that Maggie is on a bus load of seniors headed to Canada to buy drugs. He flags down the bus for a typical Hollywood ending.
My favorite line from the movie came when the aforementioned husband was asked what it's like to live with Parkinson's replied: "It's a Russian novel."
Now where were we? Oh yeah.
William Hubbard, FDA associate commissioner, explains why FDA hasn't gone after the buses to Canada: "It's so uncompassionate to go after patients." He says the FDA understands the concern about price, but warns that imports expose Americans to potential counterfeit or expired drugs.
But according to William Fallon, director of the Life Extension Foundation:
Many of the active ingredients for drugs sold in the U.S. are actually synthesized in the very countries the FDA says you cannot trust. Drug companies import these active ingredients into the United States where they end up in the expensive drugs you buy at your local pharmacy.Canada's standards for drug safety are among the world's highest.
The FDA is less tolerant of U.S. companies using the internet to import drugs from Canada. It has filed an injunction against RX Depot, an Oklahoma-based storefront & internet business, asking a judge to stop it from importing Canadian drugs for resale here. But the FDA has never filed a suit against an individual U.S. citizen for purchasing drugs from an on-line Canadian pharmacy, and it probably won't.
Still, anyone considering using an online Canadian pharmacy should exercise extreme caution. Many of them are scams. In fact, one that often appears near the top of the list when I Google "Canadian online pharmacies" is allegedly run by Russian mafia.
However, there are many reputable, safe sites. CanadaDrugs.com is one of the largest exporters of drugs to the U.S. See http://www.canadadrugs.com/.
I checked Azilect and was quoted a price of $457.05 for a 90-day supply. That price is less than half the amount ($938.69) I've been charged in the U.S. But that deal doesn't mean that I'd save money if I used this outfit. While covered by insurance, I paid only $120 for a 90-day supply; my insurance company (AARP rx)covered the rest. Even after I fell into the donut hole, I paid $517.83 -- thanks to that 50% discount -- which is only $60 more than the Canadian price.
An Option Worth Trying: Ask Your Prescribing Doctor for Samples
As I mentioned before, a member of my Parkinson's support group told me that every time he has a check-up with his neurologist, he asks for a sample box of Azilect. The samples given to doctors typically include a month's supply.